Dr SIMON L LICK is a male medical professional, specializing in Internal Medicine. He graduated in 2009 from University Of Minnesota Medical School.
GRAND ITASCA CLINIC AND HOSPITAL
1601 GOLF COURSE RD
GRAND RAPIDS
MN
557448648
Tel: 2183263401
| Npi | 1922238823 |
| Pac Id | 5092971176 |
| Professional Enrollment Id | I20120717000514 |
| Last Name | LICK |
| First Name | SIMON |
| Middle Name | L |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | UNIVERSITY OF MINNESOTA MEDICAL SCHOOL |
| Graduation Year | 2009 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialty 1 | |
| Secondary Specialty 2 | |
| Secondary Specialty 3 | |
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| All Secondary Specialties | |
| Organization Legal Name | GRAND ITASCA CLINIC AND HOSPITAL |
| Group Practice Pac Id | 8123939550 |
| Number Of Group Practice Members | 74 |
| Line 1 Street Address | 1601 GOLF COURSE RD |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | GRAND RAPIDS |
| State | MN |
| Zip Code | 557448648 |
| Phone Number | 2183263401 |
| Hospital Affiliation Ccn 1 | 240064 |
| Hospital Affiliation Lbn 1 | GRAND ITASCA CLINIC AND HOSPITAL |
| Hospital Affiliation Ccn 2 | 241360 |
| Hospital Affiliation Lbn 2 | DEER RIVER HEALTHCARE CENTER |
| Hospital Affiliation Ccn 3 | |
| Hospital Affiliation Lbn 3 | |
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| Hospital Affiliation Lbn 5 | |
| Professional Accepts Medicare Assignment | Y |
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